How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $239.88 | Facility | None | $120.23 | $173.78 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $190.55 | Professional | None | $112.20 | $138.04 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $218.78 | Professional | None | $158.49 | $173.78 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $223.87 | Professional | None | $117.49 | $151.36 | $223.87 |
BCBS Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | None | $134.90 | $158.49 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $257.04 | Professional | None | $131.83 | $158.49 | $257.04 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $602.56 | Facility | None | $162.18 | $263.03 | $602.56 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $933.25 Typical High $1,122.02 | Professional | None | $162.18 | $933.25 | $1,122.02 |
United Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $234.42 | Professional | None | $128.82 | $165.96 | $234.42 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $79.43 Typical High $97.72 | Professional | 52 · Reduced service | $66.07 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $19.50 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 25 · Same-day visit | $199.53 | $199.53 | $199.53 |
Where Missouri sits
The same service costs 2.3 times more in Alaska than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 27th of 51
$162
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.